Relapse, prelapse, and mindfulness

…by Matt Robert…

Wouldn’t it be nice if we never had to think about our addiction ever again? I posted about 10 months ago on the benefits of mindfulness in recovery. One of the points was that mindfulness informs all cognitive-behavioral approaches: it’s important to pay attention to what you’re telling yourself, and that takes practice. Practice as in mindfulness practice. Mindfulness practice helps us recognize old thoughts, feelings, and habit patterns that can lead us down the road to relapse. It keeps us on track so that we can stop, redirect and avoid those patterns. To notice and arrest a state that many call “prelapse.”

Prelapse is that state where your addicted brain is trying to juke you like a sly basketball player, fool you with cognitive card tricks, and swindle you out of your sobriety. It’s where your mind will tell you skiing might be a healthy idea to distract and reward yourself, even though it’s at the resort where you always got high in the past. It tells you to take the old route home from work, where your favorite liquor store used to beckon your car into its parking lot. It gets you to tell yourself “Pot is okay. It never triggered me in the past. I’ll just have one hit.”

smart-recovery-meetingThere are many mindfulness methods other than meditation, the one everybody associates with mindfulness. One of the things I like about SMART Recovery meetings is that people are encouraged to find what works for them, and that varies from person to person. SMART groups allow us to self-reflect on our situation and get creative with our recovery. We all have to find our own techniques.

phoneFor example, one group member used a mindfulness bell on his iPhone that would go off at random intervals. When it rang, it reminded him to look at what he was doing— and thinking. For instance, if his brain was in the default mode Marc has described, or was engaging in negative self-talk, he could catch himself, redirect his thoughts, pay attention to what he was doing, and change it. He could modify his thoughts and behavior right at that moment—the present moment— and thus better train his brain to respond differently. He could start to modify old habit patterns into new ones. This strategy embodies mindfulness without meditation.

An animated acronym worked for another member. When he noticed himself feeling triggered and wanting to use, he pictured an “escape pod” with the acronym POD painted on the side. The initials stand escape podfor Pause (when you feel yourself getting drawn in by a triggering emotion); Observe (what you’re feeling, what you are telling yourself), and Do something different (different from the habitual reaction, to start breaking the habit pattern). The “O” for “observe” launched a mindful state that came about in midstride, without having to sit still with eyes closed. The technique didn’t work right away, but eventually he got better at it and his slips diminished. In other words, he got good at being mindful when he needed to be.

From vague malaise to intense compulsion, you can’t change your behavior until you change your mind.  That’s why mindfulness practices are so important in recovery. Listening and sharing in meetings, noticing the bright colors of spring again, catching ourselves in negative self-talk, being reminded of relevant anecdotes or pithy slogans that have personal meaning. All these are mindfulness, not just sitting on a cushion chanting mantras.

There is a saying many psychologists dislike and recovery groups promote, “What’s the definition of insanity? Doing the same thing over and over and expecting different results.” It may not be an apt definition for insanity, but it certainly is for addiction. And if we don’t remain mindful, the opportunities around us can pass us by, and we’re more likely to end up stuck in the pitfalls we ignore. When I finally began to recover, I became more open to everything. I started to let go of the past and expectations, and came back to my real self. Practice helps me continue to avoid prelapse, and pay attention and notice change—particularly when it is headed in the wrong direction.



26 thoughts on “Relapse, prelapse, and mindfulness

  1. Gary June 3, 2015 at 7:48 am #

    This is a good topic for discussion…
    I have often been known to say “Long before I had a drinking problem, I had a “thinking” problem about drinking”!~ There is without a doubt a mental slip or relapse prior to ever physically engaging. With any addiction, to help curb “Stinking Thinking” it is important to develop a lifestyle change that minimizes thoughts about past using.

    I remember 24 years ago when I quit smoking cigarettes, at the time I was a Cook aboard a Scallop Dragger with a crew of 15 other men. We would make trips anywhere from 8-12 days and this is where I smoked the most, at least 1 1/2 pkgs per day. However, I thought in my mind, If I can make one trip without smoking, because mentally I felt the relationship to cigarettes was over, I would stop and that would be it.

    Most of the crew were smokers but I was determined. Whenever I got a strong craving or urge I would tell myself, “I know what this is all about, it’s about me being a slave to nicotine. However, I would usually say, “I will not smoke a cigarette today but maybe tomorrow if I feel the same way”. Of course tomorrow always turned into “Today” and I promised myself I would never smoke today!~ The thoughts, feelings and cravings I normalized as part of my involvement with nicotine over the years. In fact the last time I quit smoking was the easiest because “Mentally” I felt it was over.

  2. Gary June 3, 2015 at 8:05 am #

    For most people, nicotine is the first drug they pick up and the last one they give up. I heard one Addiction Specialist say that, “If addiction is like a furnace, as long as we engage in using a substance the Pilot Light is still lit”. There was a time in my life where I couldn’t even “imagine” not using drugs, alcohol and/or tobacco. Today I cannot imagine ever using again. I was never ever a “social” user of alcohol and/or drugs and know that to use again would be like I had never stopped.

    Knowing yourself and being “truthfully” aware is an important part of recovery. Even if a person thinks or entertains the thought of using doesn’t mean that they have to follow through with their thoughts. What I say to a lot of people in terms of relapse prevention, if or when you’re entertaining thoughts of using be sure to include the “Whole Story”. In other words, don’t just stop at the idea of using, be sure to think about all of the possible repercussions remembering what difficulties past use brought.

    Most people who relapse, only think about thier ability to get thier fix without taking the time to reflect like a knee jerk reaction. Taking time to breath and reflect can make on the difference.

  3. Gary June 3, 2015 at 8:12 am #

    One more comment…

    For me, I think it is helpful to think about my addiction, however, with the freedom and knowledge that it doesn’t define anymore. This is real freedom, knowing where I came from and “Discoverying” a whole world and parts of myself I never knew even existed!~

    • matt June 3, 2015 at 1:12 pm #

      Well said, Gary…and freedom is what happens on the other side… the backpack of boulders is gone, you don’t have to constantly watch yourself like there is another person inside you…Free to be who you really are…Addiction really is like self-slavery…

  4. Nicolas Ruf June 3, 2015 at 8:12 am #

    The author makes a good point. However, I don’t believe that “you can’t change your behavior until you change your mind”. There are many examples of ‘fake it till you make it’ working for people. The research on mindful meditation and the insula is revealing that as a mind-body link, the insula is strengthened (thickened) with mindfulness. Personally, I’m mindfully suspicious of my mind.
    On another, but perhaps related subject, I’ve been thinking about self-indulgence and addiction. Many (most? all?) addicts are familiar with indulging themselves while active, but what about in recovery? Complacency? Victimhood? Judging? Expertise? How bad I was? How good some of it was? Wallowing in ego-gratification can keep one stuck in recovery because it feels so goooooood.

    • matt June 4, 2015 at 6:39 am #

      Hi Nicolas

      Absolutely. And “fake it till you make it” is a great holding pattern in transition. But the behavior doesn’t become established as a habit till you change your mind. Your brain and your mind are still guiding the behavior.

      I agree being suspicious of your mind is a good way to be. Always trying to pay attention to who’s minding the store…the “observing ego”, witness mind….there are a lot of names for it. My head starts to hurt thinking about it.

      Can you say more about what you’re getting at in the last paragraph? To me, it sounds like someone who is not in “recovery,” (except maybe early recovery) but something more like a “dry drunk”, or some personality disorder. I think those mind states you list, are all “addictive voice”— your mind trying to get you back to your addiction.

  5. Donnie Mac June 3, 2015 at 1:15 pm #

    A) You wrote:
    “Prelapse is that state where your addicted brain is trying to juke you like a sly basketball player, fool you with cognitive card tricks, and swindle you out of your sobriety.”
    The late Robin Williams called that “His lower Power” , I think that’s just plain genius .

    B) Are we really going to chat about “Dry Drunks ? ”

    This post and reply’s are “peppered” with 12 step rhetoric , I would hate to see us being painted into that corner AGAIN .

    • matt June 3, 2015 at 5:40 pm #

      So would I. Any rhetoric. But let’s not confuse language and rhetoric. Ranting with rhetoric is what perpetuates the factionalization between approaches. Robin Williams “lower power” is 12-Step language. It’s funny because of the contrast with “higher power.” The language we need to change is “addiction” which has a negative connotation and promotes social stigma. “Recovery” is inaccurate. We’re navigating and negoiating a change, not going back to some previous state. But we’re stuck with these terms cuz they’re the ones everyone uses.

      As for B, I apologize for using the term “dry drunks” because there are as many personal interpretations and folk etymologies of what “dry drunk” means as there are for “crosstalk. “But like “crosstalk,” all of them are negative. I was just trying to point out the phenomenon of persons who get sober without working on their shit. Another 12-Step saying that is very apt: “He used to be a drunk asshole; now he’s just an asshole.” That’s what I was going for. But I agree with you. Let’s not go there. The only way to get rid of these terms is to stop using them.

      Thank you so much for this, Donnie. It brings up some big issues. We don’t want to devolve into bickering about minutiae and terms like “powerlessness” (as often happens in my meetings to my chagrin) It’s a distraction from recovery— and the amazing coalescence of views and approaches that makes this site so powerful.

      • Marc June 9, 2015 at 3:02 pm #

        Well that’s very generous, Matt. But scrupulous avoidance of terms isn’t much better than scrupulous adherence. Can’t we just accept that the language of addiction keeps evolving, like any language, and the origin of a term is less important than what it means to those who use it? “Dry drunks” is a metaphor, and metaphors are powerful. We don’t have to abandon useful metaphors because we take issue with the culture they derived from.

        I don’t like the paranoid recoil from 12-step culture, any more than I like dogmatic sycophantism, adherence uber alles. (my spellcheck doesn’t think “sycophantism” is a word, but my spellcheck doesn’t think “spellcheck” is a word either. Case in point?) Matt, I know you feel the same way as I do about this. Donnie, relax. No one’s getting painted into any corner, unless we do it ourselves unconsciously.

        • matt June 10, 2015 at 6:46 am #

          You’re right. “Getting rid of these terms” wasn’t the right language to use. Language evolves however it’s gonna evolve, and takes care of its own. What I meant was getting rid of the bickering about terms that becomes a distraction from the recovery process. So when I use them in a forum like this, I should at least be clear about what my definition is.

          Your spellcheck doesn’t recognize sycophantism as a word because it’s a program and can’t utilize the creative, productive morphology of the English language that allows us to generate new words and ideas from existing ones. And that can embellish and transform our understanding, much like the productive discussions on this blog.

          • Marc June 10, 2015 at 7:18 am #

            I kinda figured that’s what you meant. But..this diversion was worth it to hear your response. Only you could turn this into a demonstration of mechanical versus human language production!!

  6. matt June 3, 2015 at 5:42 pm #

    Oops. Sorry for ranting 🙂

  7. Gustav June 3, 2015 at 11:30 pm #

    Do you think it is possible to enjoy some alcohol moderately say if you were once addicted to cocaine?

    Thank you

    • Marc June 4, 2015 at 6:34 am #

      Yes, I think it’s okay. UNLESS drinking clouds your judgement to such a degree that you’re in real danger of going back to cocaine. I wonder if that’s your concern — otherwise I’m not sure why you’d be asking.

      Many addiction experts dispute the value of total abstinence, especially abstinence of something you were never addicted to. I’m one of them. Yet of course the recovery culture has some pretty dogmatic positions, and total abstinence is often among them.

      • matt June 4, 2015 at 6:47 am #

        …and everybody’s different. There are so many complicated factors that come into play, I think that’s why the recovery culture Marc mentioned pushes total abstinence. It’s just easier. But is it effective…?

        • Gary June 4, 2015 at 7:59 am #

          It is quite interesting how “ego’s” get caught up in language, models and/or modalities. No wonder people, or in this case, addicts, can begin to think that “they” themselves can make up thier own minds. It would appear that everybody or perhaps anybody, other than the addict, could ever know what is best for you.

          We appear to live in a world of “experts” or “specialists”, which, tend to leave addicts doubting themselves to bring about their own resolution or trust that thier minds are capable of making decisions etc…, So! in terms of “power” if addicts are disempowered due to the idea that everybody else knows best how could they ever move from environment support to supporting themselves?

          I remember hearing once that this facilitator, at a workshop, was speaking about ego and the need to be “Right”. He stated that whenever you think that you are right you’ve killed your creativity because then there are no other possibilities.

          Is it more important to have everyone understand my map of the world or would it wiser for me to be present and genuinely appreciate who they are and thier understanding. Inherently, when it comes to the so called experts they may be seen as more powerful and/or knowledgable so humbleness is essential.

          • matt June 5, 2015 at 7:10 am #

            It’s a good question, Gary. My experience as an addict and a human makes me think there has to be a flexibility of perspective and to different situations, that finally get to the desired goal… for everyone involved. In addiction, the stakes are very high which further complicates things.

            And I agree with that facilitator. As humans we all have fundamental biases, and they all come into play in addiction– big time. We don’t like change, we don’t like difference, and we really don’t like to be wrong. They’re adaptive qualities that can tend to muddy the waters of recovery…

    • KC June 4, 2015 at 10:07 am #

      I had been a “functioning” and then non-functioning cocaine addict for many years. I feel I have had both experiences in which drinking did and didn’t make use of the DOC more difficult.
      Most recently it does not, although I no longer live anywhere near places I know where to get the DOC (drug of choice).
      I think of alcohol as “an adult beverage.” I find that if I go in with the on my mind and keep it to the forefront of my cognition and do not over-drink in public or private I am fine and in fact better than pretending any chemical is a gateway. Any external factor, if I want it too, will lead me to cocaine-its a matter of choice for me and not the substance whether real or imagined. And I think that is what we are asking we “entertain” idea’s that cocaine would work like it used to wen we first started using it.
      I have not encountered coke in my drinking over the last several most (I haven’t used for about 6 most now). I also have experience in not drinking when friends and associates are drinking. I have both drank and not drank, both are equally fun and provide new experiences.
      A couple of examples: I do not drink and people sympathize and make good conversations about either they understand they have an allergy-not 12-step but actual body rejection type allergy and we make a connection. Also, when I do not over drink drinkers have a tendency to accept me better and feel less awkward and this gives me the opportunity to show the occasional person (alcoholic) who has “problems” with limiting that it is not that big of deal.
      Here’s is where I admit I have no clue if people can be that different when it comes to substances like alcohol or nicotine (or for that matter caffeine and sugar). BUT, I do feel certain natural substances like cocaine and heroine are simply built (Chemical chains) to make people want more. I do not subscribe to the disease theory nor the aspect of it that claims intolerance to all psyco-active chemicals. I have no problems not taking opiates for pain, nor do I feel an over-whelming urge for crack after i taste a beer/wine.
      I spent 7 years in AA/NA listening to people, I now feel, talked me (and themselves) into believing certain things which may or may not be true. But for me they were not true in most instances which is why I no longer go to these meetings nor would I recommend them to ANYONE without certain stipulations.
      I hope this answers you question, if not please let me know.

  8. KC June 4, 2015 at 10:21 am #


    Thanks for the post, great read.

    I would like to add a warning about current counselors who claim use “keeps the pilot light on” are dangerous and are less help than no one at all. I feel that way, and there are some studies which show abstinence based programs can and do have no-so-good effects.

    Science, pretty definitive science, shows the “pilot light is on” throughout early sobriety AT LEAST an treating people differently just because they used again, could not stand not feeling as good as they though is not he best way to keep people moving towards abstinence.

    I add this warning as a person who has been to several counselors in the US almost all of which have recommended AA/NA. Until our current healthcare structures require professional disclosure of themselves being AA/NA members to patients/clients then one needs to keep these thing in mind.

    • matt June 5, 2015 at 6:35 am #

      Thanks, KC

      I think I have met several of those counselors! The sad thing is the options that they are taught to offer are so limited that they can become as desperate, jaded and cynical as the people they are trying to help… it just perpetuates a broken system and “powerless” perspective…

      People in power who don’t understand addiction don’t see the problem because so many people appear to be getting the help they need. The “if it ain’t broke, don’t fix it” attitude continues. What if it’s broken in so many places, it’s hard to know where to begin?

  9. KC June 4, 2015 at 10:30 am #

    I wish there was an edit feature … lol … I thought there was.


  10. KC June 5, 2015 at 9:55 am #

    Western Buddhist Philosophy, with regard to deep in-sight and mindfulness, are keys to the many locks which I used to bind myself to a chemically numb stasis. Comfort from the pains of growth. Why find “mature” ways of dealing with the harsh realities of age, family and badly broken social constructs which make things appear without need of fixing.

    Many things have worked for me, none more than another, to find my way to a few days/hours of not compulsively thinking/using: the available internet with folks like you and us taking time to write, which led to the library, then to Dr Mate’s book–Hungry Ghosts, which led me to Dr Lewis which led to Dr Hart and most recently Johann Hari, a motivational interview with a Pacific Island cult. And even incorrectness of the deeply broken system of counselors and fringe religious cults like AA/NA. The social medicine answers of Canada, Europe and Great Britain which appears to be a more honest search for real answers than here in the US.

    Completely dismantling, root and branch, these broken systems is the only long-term answer and goal we who have been harmed by them can hope to achieve and strive against & for on a daily basis.For people who are in the system and who will need the system, this is our duty to ourselves and them.

    Dr Lewis’s standing up to Dr. Volkow’s “disease theory” at the meeting with the Dali Lama is a great example of change. Ours, the West, is a culture of socipathy. The beacon on the hill excuse for broken democracy is the root of my chemical use it disconnects all of use through the various parts disallowing person who have the mental and emotional capacity to make a positive difference. Apply the following definition to all things we in the west know as political-social-econmic and we have the cause of addiction and reason we have global ecological eminent disaster…apply it to our leaders and the systems they are in charge of changing…that is why doctors like Mark and Mate must continue to write and speak and change otherwise doom is not too dramatic of a word.
    “Sociopaths are often unable to control their own behaviors and their expressions of irritability, annoyance and threats when faced with situations that do not appeal to them and they often tend to resort to aggression, threats and verbal abuse. While no person is born with this disorder, sociopathic personality disorder does involve a history of persistent antisocial behavior during childhood prior to the age of 15 and if left untreated, the disorder continues into adulthood. Sociopaths could also have been influenced by different environmental factors around the age of 15 that is also one of the main reasons for the disorder in individuals.”

  11. Mark June 7, 2015 at 3:29 pm #

    Can Deep Brain Stimulation Cure Addiction?

    • Marc June 8, 2015 at 9:10 am #

      Not yet. Not even close. But there are some encouraging preliminary findings with OCD, so it’s possible that highly compulsive forms of addiction could benefit — eventually.

  12. Anonymous June 11, 2015 at 12:31 pm #

    This discussion is very good! It proves just how powerful the mind is and what a person can accomplish through changing a little bit of their thought process. Through extensive methods of help people can break their addiction just as easily as they created it.

    • matt June 14, 2015 at 4:49 am #

      Thanks for this. I like the tone of optimism in your post. It’s a crucial, yet difficult perspective to maintain when going through the hell of early recovery. It can be as simple as changing a mundane daily routine to establish and maintain a new healthier, habit. Simple, but not easy. The last line of your post is very intriguing. Can you say a little more about how methods to break the addiction can be as easy as what we did to create it?

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